When David Grossman decided the family surgical practice needed a website, his father resisted. “He just thinks differently and couldn’t see the benefits.” But David pressed on. He showed his dad how the website could help patients access forms, learn about possible complications and share experiences. “Now, he sees that it’s an important component of our medical practice.”

Such generational differences are happening in workplaces across the country, but in father-son businesses, the stakes are high. Despite a turbulent few years, family businesses remain a substantial force in the national and global economies. But keeping the business in the family takes the ability to work through assumptions, expectations and differences. The fact is, only one-third of family-owned businesses survive to the second generation.

For fathers and sons, the dynamics are complex. “The level of emotion that exists in a father and son business can be profound,” says Drew Mendoza, managing principal of The Family Business Consulting Group in Chicago.

Today’s Gen X sons think differently than their boomer dads. They bring technology skills and innovation to most workplaces, along with a desire for work-life balance. While dads still bring experience and passion, many struggle to understand a mindset where productivity doesn’t necessarily mean facetime. Even more, the relationship between fathers and sons who work together today tends to differ from the past: many consider themselves partners rather than mentor-mentee.

As the country gets ready to celebrate Father’s Day, many fathers and sons still dream of working side by side. Those who do it successfully offer insight and inspiration.

The younger Grossman, 38, says it was always his dream to work with his father, longtime Aventura surgeon, Martin Grossman, 67. The two operate as a team: together, they remove gallbladders and hernias and portions of the colons. “I learn a lot from him every day, by how he talks to patients, gives bad news and good news.” But the mentor relationship goes both ways. While becoming a doctor, David learned new minimally invasive techniques for traditional surgical procedures. He taught his dad how to remove a gallbladder laparoscopicly with smaller incisions and less recovery time for patients. David also convinced his dad to move to new, larger offices, hire more employees and update the firm logo. Change hasn’t been easy for Martin: “I’m still old fashioned,” he says.

David has had his challenges, too. He discovered getting patients to recognize and accept a younger generation can be difficult when dad has the relationships and reputation. “At first, patients only wanted to see my dad but we told them and showed them we work together and eventually they accepted me.”

Both say working together has strengthened their relationship turning it into a mature friendship. “If we disagree, we talk about it. If we want to do something different, we come to a compromise,” Martin says.

While the advantages can outweigh the challenges, experts say it is often the personal relationships that can get father-son teams in trouble — the son who only enters the business out of sense of duty or the dad who has unrealistic expectations.

“It can cause tremendous heartache when expectations and assumptions are not made clear,” says Mendoza, whose company has counseled more than 3,000 family businesses in 17 countries.